Michelle Pugle is an expert health writer with nearly a decade of experience contributing accurate and accessible health information to authority publications.

Lyndsey Garbi, MD, is a pediatrician who is double board-certified in pediatrics and neonatology.

ADHD stimming, or self-stimulatory behavior, is when a person with attention deficit hyperactivity disorder (ADHD) repeats certain movements or sounds. The reasons for stimming may vary depending on the person and their environment.

Stimming becomes troublesome when it begins disrupting everyday functioning or results in self-harm or injury. Coping with stimming may involve medication, teaching self-control techniques, and changing the person’s environmental settings.

In this article, we will describe types of stimming, factors that trigger stimming behavior, and how to manage it.

Stimming is part of the diagnostic criteria for autism spectrum disorder (ASD), but it’s not unique to people with ASD. You may notice some of these behaviors in yourself or loved ones who have ADHD and even when there’s no diagnosis of ADHD. That’s because, to some extent, many of us engage in self-stimulatory behaviors from time to time.

Consider twirling hair while talking, tapping your foot while studying, or rubbing your fingers together while nervous. The difference is that when you have ADHD, these behaviors are more severe, occur more often, and interfere with or reduce the quality of how you function socially, at school, or in a job.

There is no single reason why people with ADHD stim, but there are several theories. For example, people living with ADHD are said to have differences in brain development and brain activity that affect attention, the ability to sit still, and self-control. Stimming may be a product of these brain differences. 

An environment that’s either over- or under-stimulating may trigger stimming. Depending on the person and their environment, stimming may be calming and self-soothing or it may be done to increase stimulation and attention.  

It’s been said that over time stimming behaviors may be perceived as pleasurable in and of themselves and repeated for that reason alone. While this refers to stimming in people with autism, it may also be true for people with ADHD who engage in stimming when there is no obvious or apparent trigger. Stimming at this point may be more habitual than intentional. 

Not all stimming behaviors require management. It will be up to you and your medical care team to discuss the level at which stimming is interfering with your life. If the behavior has become particularly time-consuming or results in self-injury, such as bleeding from skin picking, it may be time to talk to a professional.

If stimming is a problem in children, avoid using punishment as a method of trying to control their behavior. Experts discussing stimming behaviors associated with autism spectrum disorder have said this punishment technique doesn’t work.  

It’s been said that the most effective method of managing ADHD symptoms in children is medication.

Medications for ADHD work to help a person control their behaviors by reducing hyperactivity and impulsivity and improving their ability to focus, work, and learn. Your doctor may suggest stimulant medications, non-stimulant medications, or a combination of both to manage stimming behaviors associated with ADHD.

Behavioral therapy may help in teaching a person to recognize and change unwanted, unhelpful, or undesirable behaviors. Working with a mental health professional who is trained in behavioral therapy can also help a person learn necessary skills to self-monitor and self-regulate without stimming. 

Cognitive behavioral therapy (CBT) goes a step further in helping a person develop self-awareness. The goal is to accept your own thoughts and feelings to improve focus and concentration.

Family-based therapies or ADHD support groups can also help by offering parents or spouses a better understanding of why their loved one stims. A professional can work with the family as a unit to ensure existing strategies are not doing more harm than good and that there’s a plan in place that everyone understands and agrees to. 

Additional forms of therapy may also be helpful as a part of the larger ADHD symptom management plan.

If you or a loved one requires extra support in managing stimming triggers and behaviors, it’s crucial to tell someone.

For example, if stimming behaviors at school are disrupting other students or are resulting in poor academic progress, an individualized education program (IEP) or 504 plan may be of use to help modify a child's workload or environment to their benefit.

IEPs and 504 plans are formal programs schools develop to accommodate children with disabilities and ensure they are not discriminated against. For example, they can be used to provide an adjusted class schedule that allows time for regular counseling or therapy.

ADHD stimming is self-stimulating behavior. People with ADHD may stim to self-soothe or to increase their focus and attention. Stimming on its own is not necessarily a problem, but it can become a problem if it interferes with everyday functioning.

Examples of stimming include visual stimming like watching water and tactile, or touch, stimming like rubbing your fingers together or chewing the inside of your cheeks. Stimming can be managed with the help of medication, therapy, and additional or educational support if needed.

Stimming doesn’t necessarily mean you or your loved one has ADHD or that you need to make changes. But if you are worried about stimming behaviors, you may want to consider reaching out to your healthcare provider or a mental health professional. Together with your medical care team, you can decide to what extent stimming is affecting your or your loved one's life, why you are stimming, and the best method of treatment for your or their specific needs. 

There is no single reason why people with ADHD stim, but stimming may be triggered by an environment that’s either over- or under-stimulating. Stimming is triggered in these situations as a way of self-soothing or increasing attention.

Stimming is a universal behavior that can occur in anyone. It is not exclusive to ADHD or any other medical condition. Stimming exists on a continuum. Some people may stim, while others may not. Some may stim occasionally and others may stim excessively. 

ADHD stimming can be managed with medication, therapy, and support. Stimulant, non-stimulant, and other medications may be used to help a person control their behavior. A person may need a combination approach to successfully stop stimming.

National Institute of Mental Health. Attention-deficit/hyperactivity disorder overview. 

Nemours Children’s Health. ADHD.

The Center for Autism Research and The Children’s Hospital of Philadelphia. Stimming: What is it and does it matter?

Visser SN, Danielson ML, Bitsko RH, Holbrook JR, Kogan MD, Ghandour RM, Perou R, Blumberg SJ. Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003-2011. J Am Acad Child Adolesc Psychiatry. 53(1):34-46. doi:10.1016/j.jaac.2013.09.001

U.S. Department of Education. The Civil Rights of Students with Hidden Disabilities Under Section 504 of the Rehabilitation Act of 1973.

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